So let's take a look at a few digital health innovations just so you can get a better sense of the range of technologies and the range of problems being solved out there. Dr. James Clark, who's an otolaryngologist at Johns Hopkins, came with an idea of how do we do a better job of diagnosing ear infections in kids, especially when a specialist isn't available to them. This could be for a number of reasons. It could be that they're in a rural community that doesn't have access to an ENT on a regular basis. It could be that they're in a part of the town or part of a community that just doesn't have a specialist. It could be that it actually is a place where a nurse or perhaps a general physician might be there, but there might not be a specialist who can actually help out. Dr. Clark basically came up with the idea of OtoPhoto, which is an artificial intelligence enhanced otoscope. It uses a digital camera in the tip and actually uses artificial intelligence software to compare the images that it would see in a child's ear with a range of images and videos of things that were positively ear infections and things that were definitively not ear infections. Because it's software, it can obviously scan through many different and make many different comparisons over a very short period of time. While it's not actually diagnosing an ear infection, it actually can give a clinician, like a nurse, an idea of whether this patient really needs to see a specialist on a very soon or in a more regular basis. This is just one example of using a combination of computer vision and artificial intelligence software to really address a specific problem of ear infections. Dr. Francoise Marvel came and was talking about is there a better way to help patients maintain medication compliance after a cardiac event. After patients had potentially an emergency room visit because of a heart attack or other cardiac event, they're often placed on a number of pharmaceuticals that will help them monitor their blood thin, their blood levels and their heart rates. But many times the patients themselves are not very good at maintaining and keeping on their pharmaceutical regimen. Dr. Marvel basically looked into how could we make this an easier way for them to keep track of their medication compliance and actually incent them to do that. Dr. Marvel started a company called Corrie Health, which is a compliance app for cardiology. It basically tracks when you've taken your pharmaceuticals and your drugs related to a cardiac event, it actually takes your vitals and basically keeps track of whether you're basically in and out of bounds of a certain range of health care compliance and what the implication is for your health status. Corrie Health was recently highlighted at the Apple software developers conference. Dr. David Efron actually asked the question of, isn't there a better way to document the results of surgery than just typing words onto the electronic health record or the electronic medical record? Dr. Efron had been around in the days of the paper record and used to talk about how he could document and actually draw pictures of the types of surgery he did, particularly gastrointestinal surgery, and what he effectively had left behind if he had changed, move things around, resected bowels, resected intestines. He could actually leave a picture of that in the electronic medical record or in the paper medical record. In the electronic medical record, he actually said there's no way of doing that. You cannot leave a picture behind so that the surgeon coming behind you will know what they're going to see before they walk in. As part of Dr. Efron's efforts, he created a product called Depictation, which is a graphic plugin into an electronic medical record. It allows the surgeon to actually to leave behind a graphic representation of exactly what surgeries they did so that the next surgeon or the next nurse coming along will know what's inside a person without having to actually do a complete CAT scan or X-ray. Dr. Greg Osgood, who is a hip surgeon and a chief of orthopaedic trauma here at Johns Hopkins, came to me and was asking, isn't there a better way to train orthopedic surgeons than using tracing paper and pins? Dr. Osgood has been teaching orthopedic surgery, particularly on the hips, for a number of years. The state of the art really is to use paper and pins and tracing pencils to basically line up broken bones and to try to train students how to reset those bones, put in the proper pins and bolts and screws and so forth that basically align hip surgeries. Dr. Osgood basically looked into using virtual reality, and basically created a series of models where he could teach his students how in three-dimensions, how basically a hip should fit together if there's a broken hip. Here you see the purple area is the existing hip. The green part is the part that has broken away. He basically uses VR to help them show where to put the screws in in the right way, how to line up the pieces of the hip, again in three-dimensional unlike a piece of tracing paper. Dr. Osgood uses this technology and his practice in his clinical teaching with his students as you can see here. Dr. Fackler is the Pediatric Critical Care Medicine fellow, and he's really focused on critical care medicine. His question was, how can we do a better job of tracking sepsis patient data in predicting and avoiding bad outcomes? Basically, how can we know when somebody's going to get sepsis or get very seriously ill from sepsis before they do it. During the COVID pandemic, a lot of the same analysis and algorithms that he was developing were actually applied to COVID patients to see which COVID patients would actually get very sick. He came up with an integrated sepsis monitoring system called Rubicon. Rubicon not only takes standard electronic medical record technology, but also incorporates a number of other sensor systems in the hospital that are monitoring very critically ill patients in a hospital. Using a number of these algorithms and data points, he can actually predict with a fair accuracy which patients are going to develop sepsis and become very seriously ill. Sepsis obviously can be life threatening and obviously can keep you in the hospital for a very long time, so it's both a quality and a cost issue to identify sepsis and try to control it. Finally, Dr. Krauss and Dr. Crone, basically, both we're looking at is there a better and more accurate way to track children with epileptic seizures then to alert their parents? Both of them are basic epilepsy experts. Their focus was there's got to be a better way. Is there a better way to track bio markers, amount of seizure, tremors, and basically strength of those tremors, and is there way to use that combination of data to better see and better understand epileptic seizures. Their product is EpiWatch, which basically uses, it first was an app basically to track various bio markers and technologies and understand when seizures happen. But most importantly, it actually integrated the Apple Watch, and for that, they were able to use all the remote sensors that are baked into the watch, including the gyroscope and other technology, not only to collect the bio information, but also understand how violent a seizure might be. Basically, using the gyroscope and other things, they can see how much the person moved and shook and understand basically exactly the level of intensity of that epileptic seizure. By doing that, they were actually able to monitor and use that in a number of different ways. What they found curiously is most interestingly, this was a very great interest to parents. As we talked about in the beginning of this, a lot of the technologies for healthcare are very focused on clinicians and health systems. But in this case, the technology is actually most interesting to consumers, to parents of children who have epileptic seizures and would like to know how intense those seizures are and what the effect has been on their children.
